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How Much Do You Know About Multiple Sclerosis?

Multiple sclerosis (MS) is a disease of the central nervous system, the brain, and spinal cord. Its symptoms can range from benign to severe. Find out more about this mysterious illness by taking this quiz, based on information from the National Institute of Neurological Disorders and Stroke (NINDS).

1. Although exact numbers are not available, approximately how many people in the United States have MS?

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Most experts estimate that there are 250,000 to 350,000 Americans with MS. About 200 new cases are diagnosed each week.

A. 100,000B. 150,000C. 250,000D. 500,000

2. MS affects the central nervous system (CNS). Which part of the CNS is affected?

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Myelin is the fatty covering that insulates the nerve cell fibers in the brain and spinal cord. MS destroys myelin. Myelin is important because it keeps messages flowing between the brain, spinal cord, and the rest of the body. When MS destroys the myelin, these messages may be slowed or even completely blocked. "Sclerosis" comes from the Greek word for "scarring" or "hardening" of the patchy areas of the CNS where the myelin has been destroyed.

A. Nerve cells (neurons)B. MyelinC. PlaquesD. Vertebrae

3. Which age group is MS most likely to strike?

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Women develop MS nearly twice as often as do men. Whites are more than twice as likely to develop MS as are other racial groups. People who live in temperate climates are more than five times as likely to develop MS as are people who live in tropical areas.

4. Although the exact cause of MS is not yet known, which factor may play a role?

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MS is considered an autoimmune disease. This means the body's immune system attacks the body's own tissues. Because MS is so much more prevalent in temperate climates than in tropical ones, researchers think the environment may have an effect. Some researchers speculate that there may be some protective agent that people in the tropics are able to acquire. Viruses also may be instrumental in the development of MS; MS often grows worse after an acute viral illness, the NINDS says. Genetics also has been implicated in MS. The risk for developing MS also rises slightly if a family member has the disease.

A. EnvironmentB. VirusesC. Family historyD. All of the above

5. How does the disease usually progress?

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There are different forms of MS:
* Relapse-remitting MS, in which the disease begins with a series of attacks, interspersed with periods of remissions that last one to two months. This is the most common form of MS.
* Primary-progressive MS, in which the person's function gradually declines, with no remissions, the NINDS says. It can lead to paralysis.
* Secondary-progressive MS, which begins with relapses and remissions and then becomes progressive. This affects about half of those with relapse-remitting MS.
* Progressive-relapsing MS, which is progressive, with acute attacks. It is rare.
* About 20 percent of people with MS have a benign form of the disease that does not progress.

A. In a series of attacks and remissionsB. In a gradual decline of function with no remissionC. The disease does not progressD. All of the above

6. A woman with MS who wants to have children should be aware that her disease may affect her pregnancy in what way?

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Researchers think that this temporary remission is related to changes in a woman's immune system during pregnancy. Up to 40 percent of women with MS have a relapse of symptoms within three months of delivery. Women with MS who are planning a family should talk to their doctor about medications they use for MS. Certain drugs should not be taken during pregnancy and while breast-feeding. These drugs may cause birth defects. Check with your doctor for a list of these drugs.

A. A miscarriage is more likelyB. Labor and delivery may be more riskyC. Her baby may develop birth defectsD. MS symptoms may temporarily ease or fade away

7. What are some of the symptoms of MS?

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Eye problems associated with MS also include red-green color distortion and blindness in one eye, the NINDS says. These eye problems tend to ease in later stages of MS. Muscle weakness can be so severe that the person has difficulty walking or standing. Other symptoms include numbness, prickling, speech problems, tremors, dizziness, loss of bowel or bladder control, difficulty concentrating, memory problems, and, occasionally, hearing loss.

A. Blurred or double visionB. Muscle weakness or partial paralysisC. FatigueD. All of the above

8. If symptoms and a physical exam suggest a diagnosis of MS, how does a doctor confirm it?

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MRI, or magnetic resonance imaging, is a medical test that uses a magnetic field, radio frequency pulses, and a computer to produce detailed pictures of internal body structures. MRS, or magnetic resonance spectroscopy, is a medical test that yields information about the brain's biochemistry. These tests can help detect plaques in the brain that may indicate MS. Visual evoked potential tests measure the speed of the brain's response to various visual stimuli and may find lesions and plaques that the scanning techniques may have missed, the NINDS says. The doctor also can test the cerebrospinal fluid for signs of MS. No single laboratory test can establish the diagnosis of MS.

9. Which therapy is often recommended for treating slowly progressing MS?

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Although corticosteroids and the hormone ACTH are given to people with an acute attack of MS, those with slowly progressing MS do not necessarily do better if they take these medications daily. Newer medications have been developed that can modify the effects of MS. Doctors will tailor their recommendations for treatment based on the patient’s situation. There is no cure for MS.

A. Corticosteroids such as prednisoneB. The hormone ACTHC. AntibioticsD. A and BE. None of the above

10. Which of these so-called therapies is NOT recommended for MS?

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Many quack cures have emerged for MS over the years. All the "cures" on the list are ineffective and some are potentially dangerous. Other so-called treatments include electrical stimulation of the spinal cord, removal of the thymus gland, and beef heart and pig pancreas extracts, the NINDS says.

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